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                      • 小兒推拿網(小兒按摩網)
                      • 育兒教育與服務,小兒推拿第一品牌
                      您的位置:首頁 >> 小兒推拿療效報告--其他小兒疾病 >> 小兒遺尿推拿治療法及注意事項

                      小兒遺尿推拿治療法及注意事項


                      《中國中醫藥報》     2011年5月25日

                       

                      小兒推拿網LOGO

                      育兒教育與服務   小兒推拿領導品牌

                      文章出處:http://health.sina.com.cn/d/2011-05-25/072722525578.shtml

                      遺尿是指3歲以上小兒睡眠中以不自主排尿為主要臨床表現的一種兒科常見病,俗稱“尿床”。該病常反復發作,雖然預防后較好,但在一定程度上影響患兒的身心健康和生長發育。

                      病因病機

                      中醫認為本病為腎氣不足,下元虛冷或病后體弱,脾肺氣虛致三焦氣化不利,肺、脾、腎三經之氣不固,膀胱失約而成。少數患兒因肝經濕熱,疏泄失常,火熱內迫,熱迫膀胱,膀胱不藏而引起。

                      西醫學認為興奮、驚恐、過度疲勞,或對新環境不適應而精神緊張,或缺乏照顧及訓練,或膀胱容量小等原因均可導致膀胱括約肌功能失調而發生遺尿。其中約有10%的患兒具有遺傳傾向。

                      推拿治療

                      1、治療原則   

                      該病的治療原則為溫腎固澀。虛證輔以健脾益氣,實證佐以疏肝清熱。

                      2、基本操作

                      1)患兒取家長抱坐位或仰臥位:補腎水300次;用全掌摩全腹,尤以下腹部為主,約5~8分鐘;按揉氣海、丹田、中極、三陰交,每穴約半分鐘。

                      2)患兒取俯臥位:捏脊3~5遍,按揉肺俞、脾俞、腎俞、大腸俞、膀胱俞,每穴約半分鐘;揉龜尾100次;擦命門、腎俞、八髎,以透熱為度。

                      3、辨證施治

                      1)下元虛寒:補腎水300次,揉腎頂300次,推三關100次,揉外勞宮100次;用較為輕柔的手法逆時針方向摩全腹延長到10~15分鐘,按揉神闕、氣海、丹田、中極,每穴約半分鐘;揉龜尾200次,推上七節骨100次;擦命門、腎俞、八髎,以透熱為度。

                      2)肺脾氣虛:補肺經300次,補脾土200次,補腎水300次,按揉板門100次;按揉百會200次;逆時針方向摩腹5分鐘,按揉氣海、關元、丹田、足三里、三陰交,每穴約半分鐘;捏脊3~5遍,按揉肺俞、脾俞、腎俞、膀胱俞,每穴約半分鐘;橫擦腰骶部,以透熱為度。

                      3)肝經郁熱:補腎水300次,清肝木100次,清心火100次,清大腸經100次,清小腸經300次;按弦走搓摩30次;用食指、中指自上而下推足膀胱經100次,推三陰交100次;推涌泉100次;橫擦腰骶部,以透熱為度。

                      適宜技術

                      1、中藥:下元虛冷者可用桑螵消散加減,脾肺氣虛者用補中益氣湯加縮尿丸加減,肝經郁熱者用龍膽瀉肝湯合縮尿丸加減。

                      2、針灸:取關元、氣海、中極、太淵、太溪、膀胱俞、腎俞、足三里等穴,中等刺激度,針尖可偏向下陰部,使針感向腹部傳導,留針10分鐘。若與有效而后不易合作的患兒,宜淺刺、速刺且不留針;灸百會、命門、關元、中極,每穴3分鐘。

                      3、埋針:在列缺穴處埋針,左右交替,一周為一療程。

                      4、穴位注射:腎俞、次髎、三陰交、夜尿點(小指第二節中點),用當歸注射液或1%普魯卡因注射,每穴0.5毫升,每次選取一穴,相互交替使用。

                      注意事項

                      1、小兒推拿治療遺尿有較好的效果,但必須辨證準確。3歲以下兒童,由于腦髓未充,或正常的排尿習慣尚未養成而尿床者不屬病理現象。個別兒童因貪睡,或懶臥不起而致尿床,只需定時喚醒排尿,不需治療。若因膀胱、尿道及附近器官炎癥,包莖,蟯蟲病,脊髓炎,大腦發育不全,隱性脊柱裂等引起的遺尿,需積極治療原發病。

                      2、注意飲食。晚餐宜少鹽飲食,晚餐后不再喝過多的水。

                      3、注意勞逸結合。白天不宜讓患兒過度疲勞,睡前不要過度興奮。

                      4、注意心理疏導,避免精神性或心理性遺尿,鼓勵孩子對治愈遺尿樹立信心,切忌歧視、責罵、處罰患兒。

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